Updated 12:35 pm, Friday, January 4, 2013

He argues that the obesity crisis is a direct result of hormonal imbalances caused by the massive amounts of sugar the food industry pumps into our diet. Our altered biochemistry, in turn, causes us to eat more and move less.

Lustig, whose video, “Sugar: The Bitter Truth,” has been viewed more than 3 million times on YouTube, expands on the evils of fructose in his new book, “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease” (Hudson Street Press, $25.95).

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Manufacturers began adding more sugar to food in the 1980s to replace fat, then seen as the villain. But processed foods, which have fiber removed and sugar added, have made us fat and sick by wreaking havoc on the hormones that control hunger and weight, Lustig says.

We can fix our hormones, he says, through lifestyle choices: reducing sugar (of course), eating more fiber, eating breakfast with protein, sleeping more and exercising — not because it burns calories, but because it lowers insulin and stress hormones.

Lustig spoke to me by phone from his home in California. Some excerpts from our conversation:

Q. It seems like you're saying to people that it's not their fault they're fat.

A. There are many causes. Virtually none of them are under your control.

Q. Don't you worry that people will give up trying to lose weight if you tell them that?

A. No. I take care of obese kids. If you say, “Eat less, exercise more,” what you are saying is, “You're exhibiting behavior that causes your obesity. Therefore, it's your fault.” That's the implicit message. So what I do, in clinic, we tell them, “Look, you didn't ask for this. You don't want to be obese. Nobody wants to be obese. Just like any disease, this is something that happens to you. Having said that, it behooves you to alter what you are doing in order to help yourself get better. Let's partner together to beat this biochemical process.”

Q. You say we have to cut down on sugar, but how is that possible if we're addicted?

A. The question is, is it OK to have it with every meal? We used to have dessert once a week. Now we have dessert once a meal. That's what changed, because now it's available. How do you make sugar less available? I equate it with alcohol. How did we make alcohol less available? With laws. We have all sorts of regulations, because we have agreed that alcohol is not a regular commodity. You can't just buy alcohol willy-nilly, and they tax it like crazy to try to reduce consumption. I think we're going to end up with the same thing with sugar, eventually. Not soon.

Q. We've seen what happens when people vilify one ingredient, such as fat. Are you concerned that targeting sugar will yield other problems?

A. Yes. We've had this issue in the past. You make one substance illegal, and things actually go in the wrong direction. Like alcohol. Did Prohibition work? Not a bit. But I'm also not suggesting we ban sugar. I'm not a crazy, lunatic zealot like I'm made out to be. We try to make it less available.